Dislocation following total hip arthroplasty using dual mobility acetabular components: a systematic review

Area of Science:

• Orthopedic Surgery
• Biomaterials Science
• Clinical Research

Background:

• Instability is a significant complication following total hip arthroplasty (THA).
• Dual mobility (DM) acetabular components have been developed to address this issue.
• Evidence on the dislocation rates associated with DM components in primary and revision THA requires systematic evaluation.

Purpose of the Study:

• To systematically review the literature on the dislocation rates associated with dual mobility acetabular components.
• To compare dislocation rates in primary versus revision total hip arthroplasty using DM components.

Main Methods:

• Systematic literature review adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
• Comprehensive search of major databases (PubMed/Medline, Cochrane Library, Embase) for English articles from January 1974 to March 2016.
• Independent data extraction by two investigators, focusing on demographics, THA type, follow-up duration, component design, and fixation.

Main Results:

• A total of 59 articles including 17,908 THAs were analyzed.
• The mean dislocation rate was 0.9% for primary THA and 3.0% for revision THA using DM components.
• Mean intraprosthetic dislocation rates were 0.7% in primary and 1.3% in revision THAs.

Conclusions:

• Dual mobility acetabular components demonstrate effectiveness in minimizing instability risk in both primary and revision THA.
• Potential benefits must be weighed against concerns regarding increased modularity and the risk of intraprosthetic dislocation.
• Further long-term studies are necessary to evaluate the functional outcomes of DM components compared to previous generations.